In summary
A CalMatters investigation unpacks the factors that result in thousands staying in California nursing homes against their will.
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That iconic line from “Hotel California” sums up the situation in which many poor nursing home residents find themselves: Despite their wish to return to the community — and despite the U.S. Supreme Court granting them the civil right to do so if they are able and willing — many end up stranded in long-term care facilities indefinitely.
A stunning investigation from CalMatters’ Jesse Bedayn unpacks the interlocking factors that have hindered thousands of Californians from leaving their nursing homes, a problem that took on new urgency amid the pandemic:
- The federal government requires nursing home staff to ask residents four times a year about their health and welfare, including whether they would like to leave. If they respond “yes,” the facility is supposed to connect them to a program to help fund and organize their transition back into the community.
- A 2016 federal report found most nursing homes “never ask, or nearly never ask” residents the required questions.
- And the California Department of Public Health doesn’t penalize facilities that don’t follow through on residents’ transition requests. In 2020, only one-third of residents’ nearly 14,500 requests to move back into the community were fulfilled.
- Nor does the Department of Public Health regulate how quickly a facility should refer a resident to a transition program. The average wait time for a transition in California is 7 months, and the average wait time residents spend on affordable housing waitlists is 2.5 years.
- And many low-income residents can’t afford to leave nursing homes: Once in long-term care, every cent of their Social Security income — save for a $35 monthly allowance — is taken to pay for the daily costs of living in the facility.
“You would be shocked by the number of residents who could live in a much less institutional level of care,” said Nicole Howell, who investigates nursing home complaints as the Contra Costa County ombudsman. “People just end up languishing there.”
When Bradley Fisher, a 63-year-old retired mechanic, returned to the community after living in a Bay Area nursing home for 14 years, his assessment was clear: “It’s the most peaceful I’ve ever been. I feel like a knot in my gut has been removed.”
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The coronavirus bottom line: As of Tuesday, California had 6,910,991 confirmed cases (+1.4% from previous day) and 77,345 deaths (+0.1% from previous day), according to state data. CalMatters is also tracking coronavirus hospitalizations by county.
California has administered 67,900,959 vaccine doses, and 72.3% of eligible Californians are fully vaccinated.
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Other stories you should know
1. Ambulance bottlenecks multiply across state
From CalMatters justice reporter Byrhonda Lyons: It should take just 20 minutes to transfer a patient from an ambulance to the hospital, but last year patients served by the Sacramento Fire Department waited for over two hours more than 700 times, Assistant Chief Eric Saylors said in a Wednesday hearing before the state Assembly’s Emergency Management Committee. “This is nothing short of criminal,” Saylors said, while emphasizing it wasn’t entirely a “COVID problem — it’s been going on for more than a decade.”
Across the state, a persistent patient surge paired with omicron’s impact on the health care workforce has resulted in worsening ambulance bottlenecks. As California’s state epidemiologist Dr. Erica Pan noted last week, fewer hospital workers means less patients admitted from the emergency room, which means ambulances have to wait longer to drop off patients, which means new 911 callers face longer response times. A couple of other data points:
- The total number of patients in California hospitals is approaching the record set last winter, though the number of COVID-positive patients may soon decline as the omicron surge hits its peak, per the Los Angeles Times. Still, San Francisco is approaching an all-time high of COVID-positive hospital patients, and a pediatric hospital in Orange County is treating a record of 15 COVID-positive kids, 14 of whom are in the ICU.
- The two main medical facilities in San Diego’s South Bay region declared “internal disasters” on Tuesday, indicating that resources are so strained patient care may be affected.
2. Workers, businesses in tough spot
Will California revive extra paid sick leave for COVID-19, and if so, when? That question is top of mind for both employees and employers alike, CalMatters’ Alejandro Lazo reports: Essential workers are weathering another, even more infectious virus surge without the protections they had at the beginning of the pandemic, whereas business groups worry that reinstating those mandates will only slow down California’s already sluggish economic recovery. Meanwhile, the gap between the state’s haves and have-nots appears to be widening: As of November, California’s low-wage sectors were down 517,000 jobs from before the pandemic compared to 309,000 jobs in high-wage sectors.
- Brittannie Gulley, who works at a Stater Bros. Markets grocery store in Norwalk: “I am the sole provider for my children. I’ll really take a hit if I have to go out: Whether I’m sick or I just have to quarantine, there’s nothing for me.”
- Rob Lapsley, president of the California Business Roundtable: “We’re very concerned that this year there’s going to be some overreaction, politically, and that’s going to hurt businesses more.”
3. Inside California’s rare new preserve
And now for some good news: The Nature Conservancy last month finalized its latest purchase in the Tehachapi foothills — a 112-square-mile preserve that will help connect Los Angeles and the San Joaquin Valley and serve as a haven for wildlife and a laboratory for scientists, CalMatters’ Julie Cart reports. The more than $65 million acquisition — buoyed by about $15 million in state grants and partnerships — protects a rare, undeveloped region of California that’s home to everything from condors to rubber boas and ranges from desert to snowy mountains.
- Brad Shaffer, director of the UCLA La Kretz Center for California Conservation Science: “It’s a crazy admixture of stuff that makes it very diverse and unique.”
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CalMatters commentary
CalMatters columnist Dan Walters: Newsom once promised to bring single-payer health coverage to the state, but he’s now content to settle for something less.
Don’t give up now: The state bar is considering whether to disband or suspend a task force exploring how to close the justice gap for many Californians, writes Jason Solomon of Stanford Law School’s Center on the Legal Profession.
It’s time for a seaweed revolution: Why would the country’s most progressive state discourage projects that seek to feed people and help drought-stricken farmers, all with methods that enhance the quality of our environment? asks Brandon Barney, co-founder of Primary Ocean.
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